AF-COS - 45260. SUBJECT . PE .
c�ty of Fr�aley �� s s s Z
AT THE TOP OF THE TWINS B U I� Q I N G P E R 1� 1 I T
�
� � R .
� `L ___„_. COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. � a 3S'
t � ,
� j ����1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE Of APPROVED 8V
�.__.11: '•� 612-571-3450 910-Ft 5 9/23/86 / /
J08 ADDRESS 5562 Fi.11more Street N.�.
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCH. 3 1. 2W@Tl TeXrace �I SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Kenco Oonstruction Inc. 10666 University Ave., Suite 105, Coon Rapids, 55433
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same 757-4052
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PHONE LtCENSE NO.
8 USE OF gU1LDING
Residential
7 CLASS dF WORK
�J NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE D REMOVE
8 OESCRIBE WORK
Construct a 34� x 24� I7Welling; a 20� x 18� Garage
SEPARATE PERMITS REQUfRED FOR
9 CHANGE OF USE FROM � i .
STIPULATIONS provide separate water and sewer servi.ces. Provide City with copy of
verifying survey before capping. Pravide a hard surface driveway. Provide
sod=in th.e front and side yards.
SEF�ER &[niATER SERVICES NOT AVAILAB,LE: Sewer 8" VCP at aenterline of Fillmore
Street. Water 6" VTP 10' West of and a� parallel with.sewer main at centerlin .
DRIVEWAY DEPRESSIONs 16' + 6' = 22' x$13.50 =$283.50 �ARNiNG
THE ClTY OF FRIDLEY DOES NOT GUARANTEE THE
ACCURACY OF UTiLITY LOCATIONS AND ELEVATIONS. BefOf@ dlggiltg C8�1 lOC81 lltill#ieS
THIS DATA IS F012 I,fy,�Q�(�{1qj(p,�( �R�S i�iy' TELEPH�NE - EL�GT�I�i - GAS �tE.
�,�Q ��� � �� ���� �► a�c�uia�n �Y ��w
v�t�w �� ccuv ��� s�,,.,--- �
SEPARATE �EiiMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTiLATtNG OR AIR CONDITION{NG.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WOfiK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED." NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APP�ICATION �- STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yqLUATION SURTAX
ND,ORDINANCES 60VERNING THIS TYPE OF WORK WILL BE COMPLIED
ITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $49,600 $24.HO
O NOT PRESUME TO GIVE AUTHOR{TY TO YIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
VISIONS F ANY OTHER STATE OR LOCAL LAW REGULATING CON-
S UC OR THE PERF ANCE OF CON UCTION. $ZH3 .00 $475.00
� �� PLAW CHECK FEE TOTAL FEE
.75 $853.55 + I�rJ
. SIGNAYUREOFCONTRACTOAOHAUTHOAIZEDAGENT IDAT 1 W EN �PRO R LI AT THIS IS VOUR PERMIT
/
~-S�GNATUFEOFOWNERFIfOWNEABUILDEAi �DATEi BLDG iN P� -� qpTE
N�; (Vj City of Fridley Effective 4/1J8c
ADDY. [] R-1 AAD A-2 �
/�1,?ER. [ ] Building Permit Application
ConstrucLion Address.�- °�--��� a' �- T
Legal Description: l,,, .�+ � `� �-�u� l �c,..rc �-. -C�22� � �
Owner Name s Address : �-r c �� o.,.� s-r Tr�c _ Tel .* � S 7` �/ O_S"Z
Contractor: � � (� (o �n .�`(� \v� Cz S �T`�( R v-e _ Tel . i
Addreas: �;^.� I �5 � oo►.s (Z,�a ��� r�,..� � sS `I�3
Attach Lo this application, a Certificate of Survey of the
lot� with the proposed construction draWn on it to scale.
DESCRIPTI01� OF IHPROPEMEh'T
LIVING AREA: LenEth �f �iidth ��_ Height _'� Sq. Ft. �� Z-
GARACE AREA: Length _� 2�' Width �_ Height �� Sq. Ft.
DECR AREA: Length ��✓ width Hgt/Ground Sq. Ft.
OTHER:
/ '
Corner Lot [) Inside Lot �] Ft. Yd. Setback �S Side Yard SetDack ��'
Type of Construction: �--��-- %�°'-" `� ��'�""'4- Estimated Cost • � � � � '��
ApFrox. Completion Date: ���-' �� � 5 g 7 �'�
Alt. A Alt B
Propose� DrSveWa�� iiidth If Nex Opening Is Desired: �� ��� s��4. � a
See Back Page for Explanation
� � ��:z�� � , Tel . 0 7S7 - yG'�Z
D�TE: APPLICAIiT:
CITY IISE ONLY
Per�it Fee ;. � �� Fee Schedule on Reverse Side
Plan Check � ��% 25'� of Buflding Permit Fee
State Surcharge � a- � �.50/�1,000 Valuation
SAC Cbarge � iJrvU ��75 per SAC Unit
Park Fte � � ��6 b Fee Determined by Engineering
Sever Nain Charge �
�� Agreement Neceasary j] Not Hecessary []
?OTII. ;
�
STIPULATIOl�S: �Qa�l� �
Qfl t-� � �� 3 , 5�
�1.�
i-.o �
. s-y''
, . � ` � _. .
�ER: ���"
--
'E AODRESSs
Ef�TER10R EN11tL41�E AYEINIQE 'y�'� COMrUTAT10N
�Ir"�� � � .
r
. .� �
:��:��
• �r: � ��yP-,
iTMCTOR: pATE : I � ' �NONE :
hETERMIME 1+OIlKINQ s0UA11E i00TAGE Of EACN: ,�`
TOtAI ExPOSEO WAIL AItEA - �
........ �;�,�9'� •a ft „ �'U'� ` . °�2 . �
- .._.
TOTAL ROOF/CE I L I NG AIIEA. ....... w�_�,�• � �q f t �t "11" ��.�� . ZO,q
TOTAI EX�OSED WALL AItEA CALCULATIQNSs
Total •xpos�d Mall
ai
b)
•n• •bov� tloor........ ��jl .� �q ��
- - -- - - �
. �
� �
, �-�,.,
qla:�d...... _ _ � r� �q lt x �����
,� +. 2.��,;`
s ��
qlaz�d...... tq ft x ����� `. . .- , ,
- ..=_
Tot�l doo� ar�• .... ..... _�� ��_.� sq f t x"U" � � Oi � Zr____(.o_�
c) Total sllding q{as� doo� a��as . �
91as�d...... - -- q'2- •q ft x ����� � �j • __1!�•.�.�i�,. .
r.._..___...�
qla�d...... - tq tt x ����� _ „ �
_.=
d) Total flreplae� wa11 ar�� -'" tq ft x'�U" �J�,, '• .. ,
r_._.__._...:
•) Total wall tra�lnq �►��
(Av��aq� 10�) . . . . .. . ....�,.�. �.� _ •4' f � x �����
f) Total n�t Nall ar�� •bow
_L :�#�• ' .P�
f�00r (Insulatad) � � � � � � • �'� �q �� 1l ��i��� .� a�� • Z'���
����
4) Toeat �I� Jot�c .��a...... �� ,a �� x „��� ,�,�' � �, �
....�-�_
Tota� toundatlo�
�r�a (Expot�d) ....... ....�......,..�2._� •q f t
h) Tot�l foundatlo� '
wlndo+� �r�� ............. ..- �q f� x ����� �,,,�/S. � �.,
.._�_.....
1) Total ��t found�tlon �
• a��a abov� 'r�d�........ � •O 't x "U" .' V • (yQ�
. .,.
TOTAL a► thru 1) • 8'-� i �
1 t 1 t� I3 1 s cM •a� as � er l�s• than 1 t� /1 � lrau h�v� Mt tl+� Intent of �
2 MCAA 1.1600a A snd 0. .
�3•I L `'IZ•? � •' vlL
paf• 1
� .. . o ..
TOTItL EXPQSEO A40F/CEILINR CA��ULATIf1NS�
.
1)
k)
li
.
�
A
,. .. �t
. ,
Tocal •xpo•ea � ' � . �.:�+►s�fi� •
roof/u�lleq �r��........ v .5 •q It
. .�• �_�, :; ;
Total �kbi luht •r��....... — •q tt x "1!" _ .��� • "` .
_ .r.�
Tot�l �oof/c�lli�q tra�lep `
•��� �Aw��� lAlt)...... • •� tt x "U" ., OZ(� . Z,o9 ,:�_ :
.r..__�.. ' : �
•�r ,s �� .
Total n�t insul�t�d ;
roo�/c�l l in9 ah�. ...... � �`�'' s� tt x"U" � t�ZZ � �� :%, �:� ��. .
, TOTAL ) i thru 1 j � 8�� : �
�.
�ocal of �� Is ths s� �s. or 1��� th�n It. you h�w �t tM Int�nt o� ,.:.
MCAtt 1.16008 A aud 0. '� ��.02 L��°� .' . v M�. ��'-:'� i
. . ; . # � l�c
. ,, .
'� . *} ..,�
,. . ��� •
• s'-�ir;� �',� ,. I
� �'. � 1
� � .i ._'"Y.
ALTEIWATE otliLD1MG ENYELO�E IfES1GN �•. �:
- ti:�:�'��
} ,. .
� utilis� ths tot�t �nwlop� •yst� �thod. th� v�1w• •st�bll�had by tM �u� ���,
t It�ws �j a�d 1�� shall not b� 9r��t�r than th� •u� of it� �1 �nd 1�2.
i. • !. •
�. ♦ �. •
►
❑
' C E IlT 1 f 1 C AT 1 A N
�.... �.�».....� �.— ....
1 h�reby ctrtlty that 1 haw c�ltui�t�d th� "U" f�ctors and "11"
�Iws h���ln and that th� bui idln� Mr� d��crib�d �t� or •x��ds th� Stat•
F Minnsaota En�r�ry► Ca�s��vatl�n Ikt.
. ��
' `� �
�
qnatur� . .
t, ��.
r:�::���
,
�
� t.
'. � :�r
,; .
� ^� .
;;
� r _,�
�
I
, �
�
! I
c. ;. � 4
i.7 � � � �
. _ � f x- ..::,r=7
Y
r
YF '� 4 �
�
��
�
�
I��
E
p A'.�•e
' � � A•
e; •.
.,.A � �
1 `,f6 •. �� �
a�• 4:
.� ,�
:�;•4.�/
d'il�.��n4
? � 6 Studs
0�lSTRUCT I ON
RAHING .SECTION:
1 Interlor at� fllm
2 .a ,ee roc.c
� � inches so t woo
b._ �. te � t ,
5 . �l inr
F Exter or a r m
WALL SECTION (INSULATEO)
--(1 Interlor air film
----( 2 �� �1."' -_� �
----( 3 �.; ns aticm
—� 4 ..5 3? Ei cxite
---{ 5 S; c�inF
—{� Exterlor a r ilm
,
av�
o.�a
d h.°
2.06
.R
TOTAL R � li.e4
U� i/R� _�n
fl . F A
.45
19.00
2,n�
.81
� n. 7
TOTAL R � 2�.17
U � 1/R � .443
RIM JOIST SECTIQ��:
--�1 lnterlor al r f I lm t1.6t1
-{ 2 51; Insulatim - 1^ . 0�:
--(3 13; �,00d 1.$°
---(4 ?S/32 rildrite 2.e<
-�5 ��;,,p .81
—�fi Exte�io� a r i lm (1.17
TOTAL R � ?��}. � _
FOUNOATION INSUI.ATIOPI REQUIRED:
Min. R-5 on entire wall OR
Min. R-10 down to frost depth
U � 1/R � _�4
fOUNDATION SECTION:
--{1 Interlor alr fllm A.(,R
—{ 2 tvro ns . . ,:
--( 3 oc c
---(4 Exterlor a r i Im r1.17
(5
(�
TOTAL R �
U � i/R - .17
SLAR ON GRADE
� 4. -
.•
�a �
� �Q � � � � � � ' � � • �
. �
, � � �� ' ° a� '. . '�� A F' ,, =
,4 ''�. '` •• . .�a. � � � ��,;;,,
c, ,
•�� Heated Slabs:
- ��':•'a� Minimum R= 8: 5
. ., ; v�-'q:
Unheated Slabs:
�• . ; Minimum R = 6.2
4� .. .
Q � �, 4 �. . � � ,0� �
• � •� a', a ..'= `�� 4•' . .
���..��i����'�.�.� �•S� ,�♦� . .
•
_� . �
I - � , � • ►� 1 • �^ 1 • v� �� � Q • Q
� : � � � �• •,' � I ,� �•� ,Q'�• �` � I I
,
. . � • , � •' . � �.
�• d � . . V�, . • . .d ,�.1
� . d,t, . . 4:, , ,.
• ..
. , 4,� � •• .. �
..
: �.' , q � • ' , : q �.' �� u 1 � ,
. .. ; �..
..4• ., � . .•
� .
• • ' • �9
: 4�. ,..• Q ; '.
. ,
. d'• " �., 4 � � �
' .r�
. . ,• .
Page 3
„ ,. •
�
�
.
I�
VENTED
� �
CONSTRUCTION R VALUC�
C�ILIN� SECTIAN (INSULATED):
� Interlor al� film ��
2 S/g ' ST' -
3 ,]_ xi I sul. 44 . �
4 Exterlo� air film sttll �•�1
TOTAL R �4�,;78
U � 1 / R � _,,,� ;,2
CEfLINC FRAMINC SECTION:
1 Intertor air film �•��
2 5 SF.
3 ns atian •'
b Interior air ilm still �• 1
5 3 inches soft wood 4.35
TOTAL R `
U� 1/R��
CEtLiNC SECTlON (IlISUI.ATEO� : n.�1
1' Interlor air film
2
3 n. l
4 Exterior air film still
TOTAL R a ��
U� 1/R�
CEILINr, FRAMIMr, SECTIO��: � ��
1• interior air fllm
2
3 n. 1
4 Exterlor air ilm still
S inches soft wood
TOTAL R = __
. . , �
UQ 1/R=
1 ,Inside alr film �•��
2
3 �
4 n.i7
5 Outside air film
� TOTAL R � _,,,__
U� 1/R�
Page 4
�
a
T
�
o�
d
>
a
a�
d
�
�
�
a
C7
2
1�
�-
� Ll�
W
J H
G Q
.-.. �
�
l�L A
2
Q
O =
�- a0
� _
v �
�
�
O
a
z
O
�
Q
r
J
v.
Q
` �
��',
v ) �
�
N
m
m
�
a
h
a+
� 0 �
t U � u �
M v O A ^�
� C'�i a�i o
arI u t�i �
� � � j �
Y s � O
� C CI u `
� '� r ; O
"�q��
o q r� e
w a
u . .r
O "" g' ++ � �'1
L L +1 C �
U � ^� � �• C.0
+r CM�O O
.pr, -^� � L 'O Q
� i � +� � �
B 4 9 � �
Y
m ,p '�O M a�+
O
� msa� �
Z
� d .`.� 5 � (�v
� �, � d .,
w.�i v�i ..�i 4 O 9 �
� M n 4 O oi 4
a`+`' : e d�`+�
w �n � r .� u
M 0 t01 .�i 4 W �
0.a�+-i F u v m
8'u�' �iOeS
� �
�
�
�
�
m
O i
O C
►Zr y
Y �
u
du �"
3z � �
sa�p � �
�
abvv� sv�
(oA i
;xF,d •�STy�
•tdd� st� �
says4M s
�
�tzQmo�nlf
SUj44$ UY
u�'sp� �
?v=Q =ooT3 �
ssawoqg
sutv3vno3 0� g
6utxuisa � �
sav=Z• ys� �, e
�
f�TS o v
� O
svtsp Y
� w
SQTLL �3�H $ �
sTv�sp 3 °'
qasoTJ .� � �
� /
., v �o r� .°: `.
sajIC3S .�ai ev n v
�
c
�
�
�
m
�
Z
�
cti
Z
►r
�
�
� �
�
0
�t
M i �
W O
V
�
�
�
�
,
V
�
1 m
C 'O 2
� � F
N
iL
�
�
t�
,
.�, M .�,
a ;a
a
N
Z
�
z
W
�
�
�
�
d
�
�
aLy
6
O
O
O
.,
b
y
M
E
M
�
W
O.
W
cn S
a�
a �n
a� w
��
Oy
w �o
W N
w
W
�E
M CA
�'a
� d
0
�
� � � N 4
F °° �
0
F H 1/1 N y' H H H N N H H H H N N N
0 0 0 0 0 0 0 0 0 0 0 0 0
�y o�n �n o 0 0 0 0 0 0 0 0 0
F 1A Pf .-1 • U1 �l1 U1 �f1 1t► n V1 O O
� .� .�
N N N H b Y1 N N N N N y N
= 2
2
v
�
W
�
�
�
F6
�C
�
aEa
i~L
V
2
�
.a
o.
• ' o
M u
+�+ e �
�+ h ..+
�. O.
M O� G�
� � 'O • �.C+ � o
o= w e e> a a u
M • +� • .r .� C q
i.�+ o+ c i e a> u u�
�+ 11 Q • dl .� 4 O �
7 �.� fi� •• U 1K O M O M
+� b Q • M �0 U.� M • p� ,1
� • p� Q O m i 7 O h r y M
�. w p t � w s� G
s u ef • O u-Ci q t a•i a+ w w
• 7 .�1 • .� �I � !. � � O y 4
s�. o m e u m: oe s x c� v
o w
a a
4
fA C <
z u t+
� 7 E
E Y N
q U
E• .� e
a .. .+
4 w ra
��
4
O
a • �
N 4
4 � " g
a � �
a
a y v
z o ~
� � O
V1 tl a'i
> o
� w � -
�" � C
r '�
a .. �
rl
�
`_
`�;
CITYOF
FR(DLEY
CIVIC CENTER • 6�31 UNIVERSITY AVE. N.E. FRiDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
ApriY 14, 1987
Kenco Cons truction Inc.
10666 University Avenue N.W., #105
Ci�on Rapi ds , NIN 55433
Re: Final Inspection at 5562 Fillmore Street N.�.� Fridley
Dear Sirs:
A final inspection was conducted on April 13, 1987 of the above address and
the following items were noted whicn must be completed before the structure
can be finaled:
l. Provide house numbers on structure by May 1, 1987.
2. Provide City with copy of verifying survey by May 1, 1987.
3. Provide sidewalk and step by May 1, 19£37.
4. Sheetrock basement wall by garage by rlay 1, 1987.
5. Provide pos t under inside landing by May 1, 1987.
6. Provide sod in the front and side yards by June 15, 1987.
7. Provide a hard surface driveway by June 15, 19a7,
We will expect the above items to be completed b�y the scheduled dates when
reinspections will be conducted to determine compliance. If you have any
questions on these items, please feel free to oontact me at 571-3450.
Sincerely,
DA L G. CLARI:
Chief Building Official
DGC/mii
sue�ECr P RMI .
City of Fridley 19 3 6 9
AT THE TOP OF THE TWINS B U I L D I N� ` P E R M I T s
�
� � RE .
� `L _ COMMUNITV DEVELOPMENT DIV. � � ���
r i � ��� PROTECTIVE INSPECTION SEC.
1 .1 �
' � 1 ���'�i � CITY HALL FRIQLEY 55432 NUMBER - iiEV, � OA[E �� � PAGE OF APPROVED BY
�"""��� ��j 612-571-3450 910-Ft 5 4�1/88 / /
�o$ aooaess 5562 Fillmore Street N, E.
t LEGAL �OT N0. BLOCK TRACT OR AODITION SEE ATTACHED
D�SCR. 3 �. I�n7�I1 `I'EY'x'3C@ SHEET
2 PROPERTYOWNER MAIIADDRESS ZIP PHONE
Willard Lawrence 5562 Fillmore Street N.E, 572-�3739
a CONTRACTOR MAtI AODR@SS ZIP PHONE I.ICENSE NO.
Same
�/ ARCHITECT OR QESIGNER MAIL ADDRESS ZtP PHONE LICENSE NO.
5 EN(iIP1EER MAII,ADDRESS ZIP PHONE IICENSENO.
8 USE OF BUIIDING '
Residential
7 CLASS OF WORK
� NEW O ADDITION �7 ALTERATION O REPAIR ❑ MOVE O FIEMOVE
8 OESCpIBE WORK
�nstruct a base�aent ba.tYL, shower and bedroom
9' CHANf3F OP USE FROM TO
STIPULATIONS
SEPqRq r�. �,�.�MIT'S
WIR���� WEATING� p RF4UIRED FO
L��B�N� �`L� c�� ,
�.
SEPARATE BERMITS ARE REQUIFED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CONSL OCCUPANCY GROUP OCCUPANCV LOAD
VENTt�ATING OR AIR CONDITIONING.
TMIS PERMIT BECOMES NULL AND VOID 1F WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AU7HORIZED IS NOT COMMENCED WITHIN 60 DAYS, OH !F GONSTRUCTION
OH WOFiK IS SUSPENDED OR ABANOONED FOR A-PEfitOD OP 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCEO. NO. DWLG. UNITS OFFSTREET PARKING
1 HEflEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 2 STAI.�S GARAGES
ANO KNOW TME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF �AWS VALUAT�ON SURTAX
AND .ORDINANCES GOVERNING THIS TYPE OF WORK WI�� BE COMPLIED $1 � SOO S• 75
WITFi WHETHER SPECIFIED HEREIN OFi NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHOFITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC GHARGE
PROVISIONS OF ANY OTHER STATE OR I.00AI LAW REGULATING CQN- $2 rj. OO
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FfE TOTAL FEE
$25.75
SIGNAiUREOFCONTRACiORORAUTHORIZEOAGENT � '. IDATEI WMEN PHOPEA ALIDATEO THIS 1S YOUR ERMtT
" ezs.e4 `' �f / ��" �
SiGNATUREOFOWN tlFOWNERBUILDERI �IDATEI tt ° B�OG �N§P ATE
.�
ti
;
s
�
�
�
�
�� ;
���k
,� � �
., :j � � �`'. °�.;��
� � � t�� �'.F
_ .. ,. , ,., . ,.
... . � . - , . ;+� ��,{r
i.
�� .�� ���"'�s" �.
. { ,
1 �P
� � � � ?�'i�,� ���
{�
� !� :
��
i�i�
� , � -. ,,,,y... � � !� �
. . _ ' . ` � , t� r" . . . �.
. . , y�,,. �>
tu� � �'��'w"��tr,�,.,
�, �'���
�;. ,, �. ,�� t
. ,
� _:r,� ��
� �� i ,
� ,�}
� `
/,� ���
U� 3
� ..
0
�a
>�;
.. A ��" , .. .
•. . w
0
�FAr� � � � � �
�, � �
t _. :�
I I N��� � 1 � �
�
i
�
i � S
� � � f '
? N Rc. o t I .�
�� � ! �
J {
a � � � �
3 � h
. c
; Q
� �\ ; s�
� � 1�
1
� �"
`>.!�
1 � �
� � � �r.�
' � ♦ ��,K
'J M1`
�� J I J f�
q �I ; �:.
� `I � .�
' ; �..�:
�
I _2�� E r
.��___ .. _ ..._ w___;�-�
� '�
�;��
� f.
�;,�
___ ._ � _ .___...��°---
N�' I ]
ADDN. [ ]
pLTER. [ ]
, �
City of Fridley
R-1 AND R-2 .
Building Permit Application
Effective �/1/86
Construction Address: 5"5 �; Z Fi//,wraye S T/y�- /��'/���y ��'�� �5����
Legal Description: �i,r 3 6��cx j��-�� T'e ry°� e - ----
_ _._ _ _
flwner ATaate & Address :�'V ���a y � L a�Y� �� P Tel .# S7� "'3 73 �'
Contractor: �a � ° _ Tel . #
�
Address•
LIVING AREA:
GASAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length
DESCRIPTI01� OF IMPROVEMENT
Width Height Sq. Ft.
Length Width Height Sq. Ft. _
Length Width Hgt/Ground Sq. Ft. ^._.
�aS °�'JP�I Y" � c�T/i sii�4i��" 9� %�e�:2"OUi�- --
Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setbaek
Type of Construction• Estimated Cost: $ t�
Approx. Completion Date:
Alt. A Alt B
Proposed DriveWay Width If New Opening Is Desired: $ �
See Back Page for Explanation
DATE: _ ( " y
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS•
APPLICANT: � �°'--•-r� Tel. �
CITY USE ONLY
$ ���� � Fee Sehedule on Reverse Side
$ ���� 25� of Building Permit Fee
$ . � �.50/$1,000 Valuation
$ � 55Q per SAC Unit
$ Fes Determined by Engineering
�
� �'^ � Agreement Necessary [ � Not Necessary [ ]
� �
�..�
�� � � ��
��Z!' ��
1 �.%1� � ,� �--�-�'""'.�,�
������
�
�
�
b
�
�
m
O
a,
>
�
U
�
w
w
w
�
w
�
A
�
�
�
0
�
�-
U
A
Z
Q
Z
O
H
a
W
�
�
LL
W
�
z
0
H-
Q N
J W
U
Z >
> A
� A
z ¢
J t/>
o �
c° �-
�
. �
Z `�
� Z
W Z
= O
z ~
a z°
H U
Z
J �
a. Q
¢
w
3
O
�
�.
O
L1.
Z
O
H
a
v
J
a
a
R
J
_
W
S
v
�
w
�
�
�
ri
�
w
N
�
�n
�
N
N
w
�
v
a
A
h
d
.� � � � �
�b� � �
.ccg ro u
v s�+ i ro u
u�i � U a'[i ro
� C1 N N 41 �
� ��.+ l�a Gl N
N O � U � �
b W 3 ro w ��
" � c01i a ro Q
w
w ro u o
' a ro v •.+
W roo'�m
z ►+ °o a •.�+
�o ro ro �
°y a ou;ro
a�+ +' +� � �t � � '
� U N .�-I 1�
N •.I C, •r1 �
u
" w "� c'o �.�+ w
cd
� N 3 � � � a
'-� � .a a � � �
� E ro � N �
>, O H C
� u o °i � `�
v �+ �
� ro e �°G' � �
'J G1 •rl 11 U1 �
C O1 W
r--�I
O'�Oa m b+� W �
�•�m � ro �H
�w�+ ro ro aro
a� o� � wr+ro
o, a�+ .-i F c�i ,ro o �
� U N N b W
� r-�
w c�
r�
.�
�
'd
.�,
�
C9 (�!
M
°a
M
a
w
o �a
u �
0
4 O
� �
� � � � � �
0 0 0 0 0
Eo 0 0 0 0
� c°�, ° �-°i ° ,°-i .
� � � � �
O ''d
•.�i
+� H
d �0 O
•k ro V N G�l N
�
O� c N ,.�.i�
3 w � � ,y �
W
„ ; � �a
,�
C� � G � ro �
e� � e ro °
b � 3
'"� '�j q N �
�,� � ° �b
�N � � e a� s� -.�i ��
v .a [ � �. � x o
w � G a�wa� A c°� o�w
N � a ro a m ro� ���
� f� GQ (.9 C� C9 Q' �
� �
�
Q
°z
F
H�^
�i
w
a
O I
O
O �
O H
r--1 �
�
o a
� H
H vEl �+
�O C �gW
U F Z
�
� w o
�
x
H
�
0
�1
U
�
H a
a �
E1
Q o
a�
� �
H �
W O
� �
O �
U
o p
� �
�n
�
� � �
v
b+
�
U
� �
�
N
GJ
� �� �
O
O
�
�
�
a�
al
w
�
O
.,�
�
U
�
a
m
. �
.,.�
a�
a
a
x
i Iz° �
a " w
a '� o �
aa
ro w �
� 3 � � iN °°
U' •.�
� � y
a�
� � O
0 o W
y x
O e G. W
� � � w
U
A � N,
s �
a I
a x �
ro
O � � I
W U N
ii al G � I
c� z � c� � �
N W U .-1 W �U
� � � � �w c�
x
z
0
H
r--1 N
u
O x O
c��H
z M I--�
�-�-1 W O
d
H � Q
�
ac
iC
�
a� � a�
A �`' A �
1 � a�i
a
±�I
tA N w
N N b
>
rn ro �
a G4 �
U
Q
�
z
H
�
�
�
0
�
O
�n
I
�
�
�,
i�v �
ro w 2
U tl E
0
0
�
vs
�
H
H
�
W
a
c7
H�
� �
x
U
��
w°a
W�
w�
� vi
H V�
�a
i �
i a
i yXT
i .�
� 3
� �
� �
� ro H
�
I
4 �N
i q .�'
�� �
I b
i y �'
� � 'c
a •.+
A 'O
� ro
C �
e w
U C
� o
N
O �
.0 u
a
��
�
a�
a 3
«
� �3� �
Building PLUMBING Pe�it rio.: ��1-� c�
Inspe�tions RESIDENTIAL APPLICATION Re�ei�ed By:
763-572-3604 CITY OF FRIDLEY nate � � (J � � : ���
DATE � ot C.� YOUR E1-MAIL ADDRESS
SITEADDRESS -��V �t - 1- Y�'I � �� V T• _
THIS APPLICANT IS: ❑ OWNER �CONTRACTOR
PROPERTY Nql,,�: l`�P� j,_OS
OWNER/ pDDRESS: 6 CITY �(7t.t2,fi/ STATF�I�ZIP SS �j
TENANT rHOr�: rI E7 — � c� � I�J' � 2!
CONTRACTOR Np�: q��y„ a B'�( Q��M
STATE LICENSE # 212 N. aw ERVICEc �Xp DATE I�- "O !
SUBMIT A COPY OF �m���
� ����
YOUR STATE ADDRESS: MN .5.513,��- CITY STATE • ZIP
LICENSE WITH PHONE '� �'�� I� J FA3C
APPLICATION
PERMIT TYPE INGLE FAMILY ❑ TWO FAMILY ❑ TOWNFiOUSE
TYPE OF WORK: ❑ �W �EPLACEMENT
- DETAILED DESCRIPTION QF WORK
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, insta.11ation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 =$15.U0. Labor cost between $300 to $500 = cost of labor x.OS =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
I3UMBER OF EACH BELOV�
BATH SINK/LAV _FLOOR DRAINS SHOWER _ WATER PIPING
BATHTUB GA5 PIPING � rmucEn�sEj SWIM1vIING POOL WATER SOFTNER ($35)
�CLOTI�S WASHER KITCHEN SINK WATER CLOSET _BACKFLOW PREV. ($15)
^ DISHWASHER LAUNDRY TRAY �WATER HEATER ($35) FOR IRRIGATION
— WATER METER OTT-IER
Permit Fee $�. 0�_ Number of fixtures @$10.00 x$10.00 =$
Surchar e .50 Number of fixtures @$15.00 x$15.00 °$
TOTAL DUE $_�. SQ Number of fixtures @$35.00 x$35.00 =$
State Surcharge = $ .50
Tota1= $
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is comptete and accurate; that the work wili be in �
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of all ork which re uires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME �� l',I'L �rfU1� DATE �
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
� �v
3